Robotic colorectal cancer surgery: perioperative and oncological outcomes at a national referral center in Mexico.

Abstract

Robotic colorectal surgery is increasingly used for technically demanding pelvic procedures, but contemporary cancer-specific experience from Latin American public oncology centers remains limited. To describe perioperative and pathological outcomes of a robotic colorectal cancer program at a national oncology referral center in Mexico. We retrospectively analyzed 75 consecutive patients who underwent robotic surgery for colorectal malignancy at the Instituto Nacional de Cancerología between June 2024 and March 2026. Colon and rectal cancer were analyzed as separate descriptive cohorts. Major morbidity was defined as Clavien-Dindo grade III or higher within 30 days. Fifty-seven patients (76.0%) had rectal cancer and 18 (24.0%) had colon cancer. No conversion to open surgery occurred (0/75; exact 95% CI 0-4.8%). Median operative time was 290 min (IQR 220-345), estimated blood loss 50 mL (IQR 30-100), and hospital stay 4 days (IQR 3-6). Major morbidity occurred in 13/75 patients (17.3%), reintervention in 12/75 (16.0%), and 30-day readmission in 12/75 (16.0%). Among rectal patients, 54/57 (94.7%) received total neoadjuvant therapy (TNT) and 11/54 (20.4%) achieved pathological complete response. The circumferential resection margin was < 1 mm in 8/57 (14.0%). Mesorectal quality was complete in 41/57 (71.9%), nearly complete in 7/57 (12.3%), and incomplete in 9/57 (15.8%). Median lymph-node yield was 9 (IQR 6-12) for rectal cancer and 25.5 (IQR 16.25-32.25) for colon cancer. This series describes robotic colorectal cancer surgery within an established national oncology service, with a case mix dominated by low rectal procedures. The findings provide contemporary perioperative and pathological quality data for continued institutional audit; comparative studies and longer follow-up are required before conclusions regarding relative effectiveness can be made.